title: Perioperative outcome of laparoscopic Roux-en-Y gastric bypass: a children's hospital experience.
abstract: OBJECTIVE
  To evaluate the perioperative safety of laparoscopic Roux-en-Y gastric bypass (LRYGB) in a freestanding children's hospital setting.
  
  
  METHODS
  Perioperative (<90 days) clinical complications of 77 consecutive patients (mean age 16.8 ± 2.1 years: mean BMI 59.4 kg/m(2), 68% female), who underwent LRYGB at Cincinnati Children's Hospital from 2002 to 2007 were examined, using standardized data collection forms that were created specifically for use in this study.
  
  
  RESULTS
  No mortality or conversion to open surgery was observed. Intraoperative complications were uncommon (3%). No anesthetic complications or transfusion requirements were observed. Median hospital stay was 3 days. Twenty-two percent of subjects had a complication from discharge to 30 days, while 13% experienced a complication between 31 and 90 days. The common types of postoperative complications included gastrojejunal anastomotic stricture (17%), leak (7%), dehydration (7%), and small bowel obstruction (SBO; 5%). Reoperation was required in 9 subjects. Operating time significantly decreased as the number of cases performed increased.
  
  
  CONCLUSIONS
  LRYGB in this case series of adolescents was associated with a low rate of intraoperative complications, with an increased rate over the ensuing 90 days. These events can be successfully managed, even in super obese adolescents.
authors.affiliation: Division of Pediatric Surgery, Juntendo University, Tokyo, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Miyano
authors.forename: Todd M
authors.initials: TM
authors.lastname: Jenkins
authors.forename: Stavra A
authors.initials: SA
authors.lastname: Xanthakos
authors.forename: Victor F
authors.initials: VF
authors.lastname: Garcia
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006776:Hospitals, Pediatric; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy; D059032:Learning Curve; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D061214:Patient Safety; D063766:Pediatric Obesity / Q000601:surgery*; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D012044:Regression Analysis; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adolescent; Complication; Laparoscopy; Roux-en-Y gastric bypass